Patients with rapid cycling bipolar disorder (RCBD) experience at least four episodes of mania, hypomania, and/or depression in a year. They suffer significant morbidity and are frequently resistant to conventional treatments. An unstable sleep/wake cycle is both characteristic of the illness and feeds back on the symptoms so as to exacerbate them. In this series of projects, we are exploring whether interventions designed to stabilize the sleep-wake and circadian systems have mood-stabilizing effects in patients with RCBD. We have previously demonstrated that extended scotoperiod may have mood- stabilizing effects. Pilot data also indicated that midday bright light might have mood-stabilizing effects, while morning phototherapy might destabilize mood in patients with RCBD. The possible mood-stabilizing effects of midday phototherapy are now being tested in a controlled clinical trial of midday bright light vs. negative ion generator. Nine patients have completed the phototherapy trial, and more are being recruited. - rapid cycling bipolar disorder, phototherapy, sleep-wake cycle - Human Subjects
